What is dissociation?

Dissociation is a mental state in which a person feels disconnected from reality. It can range in severity from daydreaming to loss of memory or identity.
When a person dissociates, they may see themselves or others as not being real, or they may feel like they’re watching themselves from above. They may also have no memories from the times they’ve dissociated, or they may feel like a different person.

Is dissociation a mental illness?

Dissociation itself isn’t a mental health disorder, and most people experience it at some point. But when dissociation happens often and feels severe, it may be a sign of a dissociative disorder, such as depersonalization/derealization disorder or dissociative identity disorder (DID).
The underlying cause of disassociation is still under debate, but it’s commonly believed to be like a coping mechanism an effort to “disconnect” from reality during times of immense stress.

Dissociation vs. Derealization vs. Depersonalization

“Dissociation,” “derealization,” and “depersonalization” are all used to talk about dissociation. While they do overlap in some ways, each term has a distinct meaning.
   •            Dissociation is the umbrella term for loss of awareness of self. It refers to feeling disconnected from thoughts, memories, your body, or the world. This may include feelings of derealization or depersonalization.
   •            Derealization is the specific feeling that the world isn’t real. Everything may look foggy or far away, or it may seem as if the world around you is a movie.
   •            Depersonalization involves feeling “out of body” or detached from your physical self. Events seem distant or dreamlike, even as you experience them.

Dissociation symptoms

Dissociation can take many different forms that range in severity. Common symptoms include:
   •            Altered senses
   •            Feeling like you’re outside your body
   •            Feeling disconnected
   •            Seeing life as dreamlike or other people as unreal
   •            Acting unusually, as if in a fog
   •            Memory gaps (inability to recall certain people, places, or events)
   •            Confusion about your identity

What does dissociation feel like?

How dissociation feels depends on how severe it is. Mild dissociation is common, and you can experience it without even noticing. If you’ve ever caught yourself daydreaming, forgetting your surroundings while you’re lost in a book, or driving down a familiar road without being able to recall the last several miles, you’ve experienced mild dissociation.  

Moderate dissociation may occur when you start to experience some moments of depersonalization and feeling like you’re not in your body. At times, certain senses may appear to be blocked, and you may have some moments of derealization.

Severe dissociation can feel disorienting or frightening. It can involve significant memory gaps, embodying multiple identities, and other serious symptoms.

Dissociation isn’t necessarily a symptom of a more serious mental health disorder, but it can be. If you have concerns, talk to a therapist for a formal diagnosis and treatment approaches.

Risk factors

Many factors can increase your chances of experiencing dissociation, including:
   •            Trauma (https://therapist.com/trauma/), especially childhood abuse
   •            Extreme stress (https://therapist.com/stress/)
   •            Emotional abuse (https://therapist.com/behaviors/abuse-domestic-violence/) or neglect
   •            Substance abuse (https://therapist.com/behaviors/addiction/)
   •            Feelings of hopelessness
   •            History of self-harm (https://therapist.com/behaviors/self-harm/)
   •            Traumatic brain injury (TBI)
   •            Neurological diseases
   •            Chronic migraines

Types of dissociative disorders

Depersonalization/derealization disorder, a person feels detached from either their body, the world around them, or both.2 This disorder may make someone feel as if they’re floating outside their own body, watching themselves experience life. They may feel emotionally or physically numb, then struggle to feel as a result. 

Dissociative amnesia

Dissociative amnesia happens when dissociation causes memory loss. It involves forgetting certain personal information, life events, entire conversations, or traumatic experiences. With treatment, some memories can likely be recovered.

Dissociative fugue

In some cases, dissociative amnesia can include dissociative fugue, in which a person finds themselves in a location with no memory of choosing to go there or traveling to it. Dissociative fugue can last anywhere from hours to months or longer. A person with this type of fugue may lose some or all of their memories, leading to extreme confusion. They may struggle to hold down a job, stay in relationships, or maintain a stable environment due to severe dissociation and memory loss. 

Dissociative identity disorder (DID)

Previously called “multiple personality disorder,” dissociative identity disorder (DID) is believed to be linked to severe childhood trauma or abuse. This disorder affects only up to 1.5% (https://www.ncbi.nlm.nih.gov/books/NBK568768/) of the population, but it’s often inaccurately portrayed and sensationalized in the media.3 It always requires professional diagnosis and care.

With DID, multiple different identities emerge within the same person. Someone who has DID may feel like a stranger to themselves and behave very differently at different times, depending on which identity is coming through. They may also experience confusion, loss of memory, and social difficulties. 

Changes in behavior across different personality states are often significant. Someone with DID may even have different handwriting for each identity.

Dissociation treatment

Treatment for dissociation depends on how severe your symp
toms are and whether or not you have underlying disorders.

Options may include:

Cognitive behavioral therapy (https://therapist.com/types-of-therapy/cognitive-behavioral-therapy/)
(CBT): CBT can help you change unhelpful thought and behavior patterns and teach you healthy coping strategies to prevent or replace dissociation.